Do Physicians Do as They Say?The Case of Mammography
Barry G. Saver, MD, MPH;
Thomas R. Taylor, MD, PhD;
Jonathan R. Treadwell, PhD;
William G. Cole, PhD
Arch Fam Med. 1997;6(6):543-548.
Abstract
| |
Objective
To assess the utility of survey-based physician policy in predicting actual mammography ordering behavior, as measured by medical record abstraction.
Design
Cross-sectional survey of practicing community physicians. Responses were correlated with data abstracted from the medical records of patients in the practices of the participating physicians.
Participants
Family and general practitioners in Washington State. Medical records of female patients aged 40 to 80 years provided data on actual mammography performance.
Main Outcome Measures
The proportions of female patients aged 40 to 49 and 50 to 80 years who had received a screening mammogram within the previous 2 years.
Results
Of the more than 100 potential predictors available, only 4 were significantly associated with screening rates for women younger than 50 years and only 3 were associated with screening rates for older women. Regression models explained only 21% to 25% of the variance in screening rates. Physician estimates of screening rates were poorly correlated with actual screening rates.
Conclusions
Practicing physicians do not know how well they screen their patients using mammography. Extensive survey data, including direct estimates of behavior, demographics, policy measures, and case scenario responses, were of limited use in predicting actual screening rates. Our results underscore the importance of using data rather than proxy measures to study physician performance.
Author Affiliations
From the Departments of Family Medicine (Drs Saver and Taylor), Psychology (Dr Treadwell), and Medical Education (Dr Cole), University of Washington, Seattle. Dr Cole is now with Information Design Seattle.
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
Reality check: perceived versus actual performance of community mammographers.
Fenton et al.
Am. J. Roentgenol. 2006;187:42-46.
ABSTRACT
| FULL TEXT
The difference between study recommendations, stated policy, and actual practice in a clinical trial
Goffin et al.
Ann Oncol 2004;15:1267-1273.
ABSTRACT
| FULL TEXT
Factors Associated With Implementation of Preventive Care Measures in Patients With Diabetes Mellitus
Streja and Rabkin
Arch Intern Med 1999;159:294-302.
ABSTRACT
| FULL TEXT
Do as I Do, Not as I Say
Paskett
Arch Fam Med 1997;6:549-550.
ABSTRACT
|
